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Objective To investigate the antibiotic resistance in clinical isolates in the Second Hospital of Hebei Medical University from 2015 to 2016.Methods A total of 16 292 strains of non-duplicate bacterial strains were collected.The isolates were subjected to identification and antimicrobial susceptibility testing on VITEK 2-Compact system.The data were processed and analyzed using WHONET 5.6 software.Results Specifically,7 961 and 8 331 strains of pathogens were collected in 2015,2016,respectively.Gram-negative bacteria accounted for 62.0％ in 2015 and 66.9％ in 2016,respectively.The top five pathogens isolated in these two years were still Klebsiella pneumoniae,Escherichia coli,Acinetobacter baumannii,Pseudomonas aeruginosa,and Staphylococcus aureus.The proportion of K.pneumoniae increased to the first place in 2016 which accounted for 16.1％.Coagulase negative Staphylococcus in blood samples decreased from 42.6％ in 2015 to 30.0％ in 2016.Vancomycin resistant strains were not found in Staphylococcus.In 2015 and 2016,the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was 56.2％ and 51.3％,respectively.The prevalence of methicillinresistant coagulase negative Staphylococcus (MRCNS)was 79.3％ and 63.1％,respectively.Enterococcus faecalis and Enterococcus faecium accounted for 25.2％ and 73.2％ respectively in the 911 strains of Enterococcus.In 2015 and 2016,3.1％ and 2.9％ of the E.faecium strains were resistant to vancomycin,respectively.In 2016,the prevalence of carbapenemresistant strains increased in K.pneumoniae,E.coli and E.cloacae.K.pneumoniae showed increasing resistance rate to all the antimicrobial agents tested except for gentamicin and amikacin.The percentage of the K.pneumoniae strains resistant to imipenem and meropenem increased from 19.3％,18.5％ in 2015 to 24.2％,23.1％,respectively.A.baumannii isolates were still highly resistant to the commonly used antibiotics in these two years,but relatively susceptible to polymyxin B,tigecycline,cefoperazone-sulbactam and minocycline (＜30％ resistant).P.aeruginosa isolates showed lower resistance rate to amikacin (11.7％),cefoperazonesulbactam (15.5％),piperacillin-tazobactam (18.7％),ceftazidime (20.1％),cefepime (21.9％).P.aeruginosa presented a trend of declining resistance to all the antimicrobial agents tested from 2015 to 2016,except aztreonam,to which the resistant P.aeruginosa strains increased from 27.0％ in 2015 to 34.7％ in 2016.Conclusions The antimicrobial susceptibility profile of clinical bacterial isolates has been changing constantly.We need to adopt effective infection prevention and control measures in hospital and further standardize and control the use of antibacterial agents.
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Objective To evaluate the application of atherogenic index of plasma (AIP) and intima-media thickness of carotid artery (CA-IMT) in renal arteriolar sclerosis patients with chronic renal failure.Methods One hundred and twenty nine patients with chronic renal failure patients underwent ultrasound-guided percutaneous renal biopsy from October 2013 to June 2014,the biopsy results showed that renal arteriolar sclerosis was identified in 72 patients (atherosclerosis group) and no renal arterioles sclerosis was detected in 57 patients (non-atherosclerosis group);71 healthy adults were enrolled in the study as controls.The age,height,body weight,systolic and diastolic blood pressure,the indexes of blood lipid and renal function were documented and compared among three groups.The correlation of AIP and CBMmax of common carotid artery and carotid bifurcation with blood lipid level and renal function was analyzed.Results There was significant difference in body weight among patients with atherosclerosis [(70.77 ± 14.27) kg],without atherosclerosis [(60.63 ± 12.12) kg] and the controls [(64.20 ± 8.13) kg] (t =3.071,3.391,all P ＜ 0.05).The TG [(2.43 ± 1.61) mmol/L vs.(1.02 ± 0.37) mmol/L],TC [(7.40 ± 8.80) mmol/L vs.(4.53 ±0.67)mmol/L],LDL-C[(4.40 ±2.13) mmol/L vs.(2.85 ±0.70) mmol/L],AlP[(0.15 ± 0.351) vs.(-0.127 ± 0.184)] of the atherosclerosis group were higher than those of control group (t =5.975,2.252,2.614,-5.467,all P ＜ 0.05).The HDL-C of atherosclerosis group was lower than that of control group [(0.78 ±0.16) mmol/L vs.(1.29 ±0.21) mmol/L,t =4.750,P ＜0.05].The Scr[(117.24 ± 94.27) mmol/L vs.(64.16 ± 13.42) mmol/L],BUN [(6.73 ± 3.58) mmol/L vs.(4.66 ± 1.08) mmol/L] of the atherosclerosis group were higher,and the GFR was lower [(65.60 ±23.00)ml · min-1 · 1.73 m-2 vs.(124.78 ± 24.35)ml · min-1l.73 m-2,t =5.118] than those of control group (t =4.730,4.702).The Scr of the atherosclerosis group was higher,and the GFR was lower [(65.60 ± 23.00) ml · min-1 · 1.73 m-2 vs.(95.60±53.00)ml · min-1 · 1.73 m-2,t =3.514] than those of the non-atherosclerosis group [(117.24 ± 94.27) mmol/L vs.(71.35 ± 42.18) mmol/L,t =3.690].There were positive correlation between TG and LDL-C (r =0.828,0.323,P ＜ 0.05) and negative correlation between AIP and HDL-C (r =-0.489,P ＜0.05).There was positive correlation of CBMmax with Scr,BUN and AIP (r =0.394,0.289,0.528,all P ＜ 0.05),and negative correlation between CBMmax and GFR (r =-0.277,P ＜ 0.05).Conclusion Body weight,GFR,AIP and CBMmax are useful indicators in evaluation of renal arteriolar sclerosis in patients with chronic renal failure.AIP is a sensitive index for abnormal blood lipid level.AIP and CBMmax are important risk factors in chronic renal failure patients with renal arteriolar sclerosis.
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BACKGROUND:Urine-derived stem cels are most likely to come from the kidney tissue, and therefore, these cels are more adaptable to kidney microenvironment, providing a new option for the treatment of kidney diseases. OBJECTIVE: To explore the therapeutic efficacy of human urine-derived stem cels on chronic nephropathy rats. METHODS:The fresh urine samples of healthy people were colected, and then human urine-derived stem cels were extracted and cultured in vitro. Twenty Sprague-Dawley rats were used to prepare chronic nephropathy models, and given injection of human urine-derived stem cel suspension (experimental) or normal saline (control) into the renal cortex, respectively. Another 10 healthy rats were used as controls. Therapeutic effects on renal function were assessed by detection of serum creatinine level and glomerular filtration rate in the three groups. The kidney tissues of rats were taken and observed histomorphologicaly in each group. RESULTS AND CONCLUSION: Human urine-derived stem cels were found to remarkable improve rat’s renal function as wel as reduce the histomorphological changes in the kidney tissues of rats. Compared with the control group, the serum creatinine level was decreased while the glomerular filtration rate was increased significantly in the experimental group; CD68 expression and infiltration of interstitial inflammatory cels were also markedly reduced in the experimental group. To conclude, human urine-derived stem cels can improve the renal function of chronic nephropathy rats.